New solution for ER crisis

SC immediate care facility among those aimed at reducing strain on hospital ERs

The Immediate Care Center, which is under construction at 1200 E. Main St., will act as both a primary-care and urgent-care facility. The facility is among those aimed at reducing strain on hospital emergency rooms.

Published: Wednesday, March 6, 2013 at 3:15 a.m.

Last Modified: Tuesday, March 5, 2013 at 12:06 p.m.

When the doors of the emergency room swing open, there's no telling who might enter.

Some who rush inside are in trauma and in need of immediate help. Others who visit the emergency room seek treatment for a runny nose, sore throat or a minor cough.

The Federal Emergency Medical Treatment and Labor Act requires emergency departments to screen and stabilize every patient who walks, limps, crawls or is rolled into the door, no matter the severity of their condition.

As a result, the emergency room is often crowded — a problem many hospitals across the country are actively trying to cure.

“Many (hospitals) are looking at ways to redirect patients that use their local ER as their primary care facility,” said Shalama Jackson, communications manager with the South Carolina Hospital Association. It's about “looking at ways to help serve the community outside of the hospital ER.”

She adds that while emergency rooms are open 24 hours a day, seven days a week, it is one of the most expensive places to receive care.

Access Health, a nonprofit in Spartanburg committed to connecting lower income residents to affordable health care options, stresses the importance of finding a physician for their clients.

“So many people don't have insurance or a physician,” said Carey Rothschild, director of the organization. “So what do they do?”

The answer: They go to the emergency room, where they pay about $250 for a sore throat — nearly five times what they would pay at a primary care center.

“We want to keep people out of the emergency room for non-emergent conditions,” she said. “An emergency room is probably the least affective and most expensive way for people to get primary care.”

After-hours care

But there's another problem: Many primary care facilities aren't open after business hours.

“A lot of people don't get off work until 5 and can't make it to the doctor's office,” Rothschild said.

According to the Center for Disease Control and Prevention, two-thirds of emergency room visits occur after primary care offices are closed.

Spartanburg Regional Healthcare System, which has one of the busiest emergency departments in the state, receiving more than 100,000 patients a year, is developing a new health care model.

It will serve as an option to many of the primary-care patients who visit their ER and will have extended hours.

The Immediate Care Center, which is under construction at 1200 E. Main St., will act as both a primary-care and urgent-care facility.

“It's a way of decompressing a very busy ER,” said Dr. Nick Ulmer, a vice president of clinical services with the hospital's medical group. “Whether you have a broken arm, a nail in your foot or a common cold, you can come here and get treatment.”

It's a similar model to what many hospitals are doing throughout the state in an effort to eliminate some of the ER's traffic, according to the SCHA.

“I can't tell you how many other hospitals have done something like this, but there are a number,” Jackson said.

The Immediate Care Center will consist of a staff of about 12 licensed health care professionals — doctors, nurses and radiologists. Walk-ins will be welcome, but appointments can also be made.

Ulmer says the model will provide a convenient, more timely option for patients with less acute situations.

But it's also an option for the many patients who don't have a primary-care physician.

“It will give patients a chance to establish a medical home,” Ulmer said. “Without medical homes, patients often seek care in the emergency room because they don't have a relationship with a primary-care physician.”

What makes it different

Sara Beth Hammond, vice president of Spartanburg Regional Physicians Group, says the model promises to be unlike any other primary-care center in the Upstate.

Medical staff will be available by telephone 24 hours a day to assist patients with appointments or medical questions.

Ulmer says it will differ from most doctor's offices in that a patient won't have to see so many different people during a visit.

Patients who enter the facility won't have to see someone behind a sliding glass window — a common sight in most doctor's offices — before being seen by a doctor.

A clinical staff person seated at a table in front of the door will assess the patient immediately and send them into separate rooms to wait for a doctor. Many of the rooms will feature couches that flip out into beds, comforting music and TVs that display need-to-know health information.

“Normally when you go to a doctor you check in with somebody, a different person calls you into a room, and then sometimes a different person comes in and does your vital signs, then the doctor does his deal,” Ulmer said. “There will be so many people here that the process will hopefully be a lot faster. And you will never be left alone — you will be engaged the whole time.”

It is hoped, Ulmer said, that this engagement will keep patients coming back.

He said patients will be asked about their insurance or how they will pay once they get into the rooms to avoid embarrassment.

“A nurse will swipe your credit card and collect your co-pay,” he said. “And then she will ask why you're here and then she will queue up the doctor.”

When the doctor leaves, the same nurse will come back and complete the checkup, Ulmer said.

“Everything happens in the room. It's all about privacy.”

Hammond said the model is about maximizing both the patients' and the physicians' time to ensure a great experience.

“Improved access to care and shorter wait times will yield efficiencies that put more focus on the patient.”

Rothschild said the Immediate Care Center, which is expected to open later this month, will be a welcome addition to the community.

But it's not just good because it might reduce ER crowds or provide people more access to health care, it's good for everyone, she said.

“When more people are having to use the emergency room because they don't have access, it costs all of us.”

<p>When the doors of the emergency room swing open, there's no telling who might enter.</p><p>Some who rush inside are in trauma and in need of immediate help. Others who visit the emergency room seek treatment for a runny nose, sore throat or a minor cough.</p><p>The Federal Emergency Medical Treatment and Labor Act requires emergency departments to screen and stabilize every patient who walks, limps, crawls or is rolled into the door, no matter the severity of their condition.</p><p>As a result, the emergency room is often crowded — a problem many hospitals across the country are actively trying to cure.</p><p>“Many (hospitals) are looking at ways to redirect patients that use their local ER as their primary care facility,” said Shalama Jackson, communications manager with the South Carolina Hospital Association. It's about “looking at ways to help serve the community outside of the hospital ER.”</p><p>She adds that while emergency rooms are open 24 hours a day, seven days a week, it is one of the most expensive places to receive care.</p><p>Access Health, a nonprofit in Spartanburg committed to connecting lower income residents to affordable health care options, stresses the importance of finding a physician for their clients.</p><p>“So many people don't have insurance or a physician,” said Carey Rothschild, director of the organization. “So what do they do?”</p><p>The answer: They go to the emergency room, where they pay about $250 for a sore throat — nearly five times what they would pay at a primary care center.</p><p>“We want to keep people out of the emergency room for non-emergent conditions,” she said. “An emergency room is probably the least affective and most expensive way for people to get primary care.”</p><h3>After-hours care</h3>
<p>But there's another problem: Many primary care facilities aren't open after business hours.</p><p>“A lot of people don't get off work until 5 and can't make it to the doctor's office,” Rothschild said.</p><p>According to the Center for Disease Control and Prevention, two-thirds of emergency room visits occur after primary care offices are closed.</p><p>Spartanburg Regional Healthcare System, which has one of the busiest emergency departments in the state, receiving more than 100,000 patients a year, is developing a new health care model.</p><p>It will serve as an option to many of the primary-care patients who visit their ER and will have extended hours.</p><p>The Immediate Care Center, which is under construction at 1200 E. Main St., will act as both a primary-care and urgent-care facility.</p><p>“It's a way of decompressing a very busy ER,” said Dr. Nick Ulmer, a vice president of clinical services with the hospital's medical group. “Whether you have a broken arm, a nail in your foot or a common cold, you can come here and get treatment.”</p><p>It's a similar model to what many hospitals are doing throughout the state in an effort to eliminate some of the ER's traffic, according to the SCHA.</p><p>“I can't tell you how many other hospitals have done something like this, but there are a number,” Jackson said.</p><p>The Immediate Care Center will consist of a staff of about 12 licensed health care professionals — doctors, nurses and radiologists. Walk-ins will be welcome, but appointments can also be made.</p><p>Ulmer says the model will provide a convenient, more timely option for patients with less acute situations.</p><p>But it's also an option for the many patients who don't have a primary-care physician.</p><p>“It will give patients a chance to establish a medical home,” Ulmer said. “Without medical homes, patients often seek care in the emergency room because they don't have a relationship with a primary-care physician.”</p><h3>What makes it different</h3>
<p>Sara Beth Hammond, vice president of Spartanburg Regional Physicians Group, says the model promises to be unlike any other primary-care center in the Upstate.</p><p>Medical staff will be available by telephone 24 hours a day to assist patients with appointments or medical questions.</p><p>Ulmer says it will differ from most doctor's offices in that a patient won't have to see so many different people during a visit.</p><p>Patients who enter the facility won't have to see someone behind a sliding glass window — a common sight in most doctor's offices — before being seen by a doctor.</p><p>A clinical staff person seated at a table in front of the door will assess the patient immediately and send them into separate rooms to wait for a doctor. Many of the rooms will feature couches that flip out into beds, comforting music and TVs that display need-to-know health information.</p><p>“Normally when you go to a doctor you check in with somebody, a different person calls you into a room, and then sometimes a different person comes in and does your vital signs, then the doctor does his deal,” Ulmer said. “There will be so many people here that the process will hopefully be a lot faster. And you will never be left alone — you will be engaged the whole time.”</p><p>It is hoped, Ulmer said, that this engagement will keep patients coming back.</p><p>He said patients will be asked about their insurance or how they will pay once they get into the rooms to avoid embarrassment.</p><p>“A nurse will swipe your credit card and collect your co-pay,” he said. “And then she will ask why you're here and then she will queue up the doctor.”</p><p>When the doctor leaves, the same nurse will come back and complete the checkup, Ulmer said.</p><p>“Everything happens in the room. It's all about privacy.”</p><p>Hammond said the model is about maximizing both the patients' and the physicians' time to ensure a great experience.</p><p>“Improved access to care and shorter wait times will yield efficiencies that put more focus on the patient.”</p><p>Rothschild said the Immediate Care Center, which is expected to open later this month, will be a welcome addition to the community.</p><p>But it's not just good because it might reduce ER crowds or provide people more access to health care, it's good for everyone, she said.</p><p>“When more people are having to use the emergency room because they don't have access, it costs all of us.”</p>